Pediatric cardiology Percutaneous atrial septal defect closure by using jugular venous access in a case with interrupted inferior vena cava

Abstract

Femoral venous approach is the classical route of percutaneous atrial septal defect (ASD) closure. But in certain circumstances alternative routes are used. In this report percutaneous ASD closure in a case with interrupted vena cava by jugular venous approach is discussed. Percutaneous closure through femoral venous route was planned in a 6-year-old girl with ASD. Because of interrupted vena cava the jugular venous route was used. Having knowledge of this anatomical variation is important for interventionalists before performing femoral venous approach. Percutaneous transjugular venous access is a feasible alternative route in paediatric population for ASD closure.

Retrograde Percutaneous Closure of a Perimemberanous Ventricular Septal Defect with an Occluder Device in a Child with Interrupted Inferior Vena Cava

“…In this situation, we believed that the transcatheter closure of the PM VSD through internal jugular access would have been imprecise, increased the duration of the procedure, and ultimately been unsuccessful. However, the transcatheter closure of ASD and patent ductus arteriosus has been established using an internal jugular approach in many previously reported cases of interrupted IVC [7,8]. If the size of the PM VSD had been > 6 mm, we would not have been able to use the ADO II, as the maximum available waist diameter of the device is 6 mm.…”

Transjugular closure of secundum atrial septal defects

“…There have been few case reports using the transjugular technique for closure of ASDs . Transjugular closure was performed with conventional delivery devices through the femoral vein, mainly for patients with an interrupted inferior vena cava.…”

“…Transcatheter closure of secundum atrial septal defects (ASD) is predominately performed through the femoral vein . However, under some special circumstances, such as vena cava obstruction or interruption, transjugular or transhepatic veins are alternative access sites . We have developed a steerable delivery system for the practice of transjugular closure of secundum ASDs, and report our clinical outcomes.…”

Hybrid closure of a large atrial septal defect using Occlutech Flex II septal occluder in a patient with interrupted inferior caval vein

“…Alternative percutaneous approaches include trans-hepatic and trans-jugular access. 3,4 However, trans-hepatic access carries a significant risk of haemorrhage when using large introducer sheaths necessary for large devices, and trans-jugular access imposes significant technical difficulties concerning orientation of device during deployment particularly with large defects.…”